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Grapefruits May Overdose You.

It's the time of year when citrus fruits are a Thing - at least here in Germany, they are mostly available in autumn and winter, and that's the time of year when they are best anyways. Mostly unrelated to this, we recently had a conversation about chinine and bitter lemon and from that started to wonder what chemical causes the bitter taste in grapefruit, which led to a visit to Wikipedia and... oh wow. I wasn't aware of grapefruit being such an interesting player when it comes to drug interaction!

I really like the taste of grapefruit, especially of the more mild, modern variations. I still remember that when I was a child, they were very sour and often also quite bitter, and generous amounts of sugar were added to the fruit. Which was eaten by cutting it in half, then cutting around the outer rim of the fruit with a special grapefruit knife, and then spooning out the flesh. After the addition of said generous amounts of sugar, of course. (These days I usually peel them and remove the inner skins between the segments.)

If you're taking medication, though, citrus fruits or their juice might not be the best choice - quite a lot of drugs (and caffeine) interact with the stuff. Or, more precisely, citrus fruit contents interact with enzymes and transport proteins in the body and can cause both underdosage and overdosage, depending on consumption and the type of drug. It's quite fascinating!

You can read more about the fruit on the grapefruit wikipedia page, and more about its effects on drugs on this page.
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Comments 4

Harma on Montag, 15. November 2021 17:50

Yep, some people aren't allowed to eat grapefruits because of medicines, but the instructions for use mostly are very clear about this.

Yep, some people aren't allowed to eat grapefruits because of medicines, but the instructions for use mostly are very clear about this.
Miriam Griffiths on Dienstag, 16. November 2021 09:36

I remember this from pharmacology lectures! Another one to watch out for is St John's Wort, in particular because it is marketed for depression but interacts with antidepressants and can both stop them working properly and increase the risk of side-effects.

I remember this from pharmacology lectures! Another one to watch out for is St John's Wort, in particular because it is marketed for depression but interacts with antidepressants and can both stop them working properly and increase the risk of side-effects.
Katrin on Donnerstag, 18. November 2021 15:45

The only thing I knew about St John's Wort was that it could cause easier sunburn. Similar to drinking Earl Grey tea before going into the sun - not a good idea...

The only thing I knew about St John's Wort was that it could cause easier sunburn. Similar to drinking Earl Grey tea before going into the sun - not a good idea...
Heather on Dienstag, 16. November 2021 12:42

I got halfway through the first sentence and thought "interactions!" So it's good to know that some of my training stuck.

In the UK, medicine in hospital and from public pharmacies may still only mention grapefruit in the really, really small print on the leaflet so patients and professionals don't know about it. It's also more than possible that a medical professional is giving tablets one end of an organisation while a dietary professional is dishing out grapefruit juice at the other, with both and the client unaware of any issue. So always good to check everything with everyone.

Another favourite is medication leaflets specifying "pink grapefruit" or "grapefruit" then using them interchangeably, leaving everyone confused.

I got halfway through the first sentence and thought "interactions!" So it's good to know that some of my training stuck. In the UK, medicine in hospital and from public pharmacies may still only mention grapefruit in the really, really small print on the leaflet so patients and professionals don't know about it. It's also more than possible that a medical professional is giving tablets one end of an organisation while a dietary professional is dishing out grapefruit juice at the other, with both and the client unaware of any issue. So always good to check everything with everyone. Another favourite is medication leaflets specifying "pink grapefruit" or "grapefruit" then using them interchangeably, leaving everyone confused.
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Montag, 20. Mai 2024

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